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Clinical Value of Detecting Fecal Calprotectin by Using Colloidal Gold Assay in Screening or Diagnosing Crohn’s Disease 胶体金法检测粪便钙保护蛋白在克罗恩病筛查和诊断中的临床价值

4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterology Research and Practice

Pub Date : 2023-11-09 DOI: 10.1155/2023/8866828

Wangdong Zhang, Yanyun Fan, Meijun Chen

Background. Crohn’s disease (CD) is a chronic inflammatory disease, and its incidence is gradually increasing. Thus, the use of a simple and convenient examination method to detect CD in the natural population as early as possible is crucial. This study is aimed at using the colloidal gold semiquantitative assay to detect fecal calprotectin (FCP) and determine whether it is helpful in screening or diagnosing CD. Methods. Using a prospectively maintained database, 59 patients with CD were analyzed using FCP measurement. Subsequently, 76 patients and 89 healthy individuals were assigned to the gastrointestinal dysfunction and control groups, respectively. To aid in the screening or diagnosis of CD, the receiver operating characteristic curve was used to determine the diagnostic efficacy of FCP thresholds. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were presented with 95% confidence intervals (CIs). Results. Patients with CD showed significantly higher FCP levels. Compared with the healthy population, when the FCP level cut-off was 15 μg/g and 60 μg/g, the sensitivity, specificity, PPV, and NPV for CD diagnosis were 98.3% (CI, 95.0%–100%) and 78.0% (CI, 67.4–88.6%), 84.3% (CI, 76.7%–91.8%) and 98.9% (CI, 96.7%–100%), 80.6% (CI, 71.5%–89.7%) and 97.9% (CI, 93.7%–100%), and 98.7% (CI, 96.2%–100%) and 87.1% (CI, 80.6%–93.6%), respectively. The AUCs were 0.969 (CI, 0.941–0.997). Compared with the gastrointestinal dysfunction group, using the same FCP level cut-off, the sensitivity, specificity, PPV, and NPV for CD diagnosis were 98.3% (CI, 95.0%–100%) and 78.0% (CI, 67.4%–88.6%), 71.1% (CI, 60.9%–81.3%) and 89.5% (CI, 82.3%–96.7%), 72.5% (CI, 62.7%–82.3%) and 85.2% (CI, 75.7%–94.7%), and 98.1% (CI, 94.5%–100%) and 84.0% (CI, 76.0%–92.0%), respectively. The AUCs were 0.908 (CI, 0.856–0.960). Conclusion. Detecting FCP by using the colloidal gold semiquantitative assay can be effective in screening and adjunct diagnosing of CD.

背景。克罗恩病(CD)是一种慢性炎症性疾病，其发病率逐渐增加。因此，采用一种简单方便的检测方法，尽早在自然人群中检测出乳糜泻至关重要。本研究旨在利用胶体金半定量法检测粪便钙保护蛋白(FCP)，以确定其对乳糜泻的筛查或诊断是否有帮助。使用前瞻性维护的数据库，使用FCP测量对59例CD患者进行分析。随后，76名患者和89名健康人分别被分配到胃肠道功能障碍组和对照组。为了帮助筛查或诊断CD，使用受试者工作特征曲线来确定FCP阈值的诊断效果。敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV)以95%置信区间(ci)表示。结果。乳糜泻患者FCP水平明显升高。与健康人群相比，当FCP水平临界值为15 μg/g和60 μg/g时，诊断CD的敏感性、特异性、PPV和NPV分别为98.3% (CI, 95.0% ~ 100%)和78.0% (CI, 66.4 ~ 88.6%)、84.3% (CI, 76.7% ~ 91.8%)和98.9% (CI, 96.7% ~ 100%)、80.6% (CI, 71.5% ~ 89.7%)和97.9% (CI, 93.7% ~ 100%)、98.7% (CI, 96.2% ~ 100%)和87.1% (CI, 80.6% ~ 93.6%)。auc为0.969 (CI, 0.941 ~ 0.997)。与胃肠功能障碍组相比，采用相同的FCP水平临界值，诊断CD的敏感性、特异性、PPV和NPV分别为98.3% (CI, 95.0% ~ 100%)和78.0% (CI, 67.4% ~ 88.6%)， 71.1% (CI, 60.9% ~ 81.3%)和89.5% (CI, 82.3% ~ 96.7%)， 72.5% (CI, 62.7% ~ 82.3%)和85.2% (CI, 75.7% ~ 94.7%)， 98.1% (CI, 94.5% ~ 100%)和84.0% (CI, 76.0% ~ 92.0%)。auc为0.908 (CI, 0.856 ~ 0.960)。结论。胶体金半定量法检测FCP可有效筛查和辅助诊断CD。

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引用次数: 0

Intestinal Ultrasound Combined with Blood Inflammatory Markers Is a More Efficient Tool in Evaluating Severity of Crohn’s Disease: A Pilot Study 肠道超声联合血液炎症标志物是评估克罗恩病严重程度的更有效工具:一项初步研究

4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterology Research and Practice

Pub Date : 2023-11-08 DOI: 10.1155/2023/2173396

Huaying Fang, Jie Liu, Kai Qian, Xuemei Xu, Zhaolong Li, Li Xie, Menghan Sun, Song Wang, Jiaqin Xu, Chaolan Lv, Bo Wang, Weiyong Liu, Gengqing Song, Yue Yu

Background and Aims. Intestinal ultrasound (IUS) is considered a nonirradiating, noninvasive, well-tolerated, and valuable tool for objectively assessing Crohn’s disease (CD) activity. However, there is no widely accepted intestinal ultrasound scoring system. This study is aimed at evaluating the efficacy of IUS key parameters, the International Bowel Ultrasound Activity Score (IBUS-SAS), and IBUS-SAS combined with blood inflammatory markers in assessing CD activity. Methods. 40 CD patients were reviewed in this retrospective study and were divided into the moderate-severe group (

n = 25

) and nonmoderate-severe group (

n = 15

) based on a simplified endoscopic score of Crohn’s disease (SES-CD). Double-balloon enteroscopy/colonoscopy were reviewed by three gastroenterologists. A transabdominal ultrasound was performed by two ultrasound specialists. Blood inflammatory markers were measured from morning samples. Results. In evaluating moderate to severe CD patients, (1) IBUS-SAS had a good predictive effect with an area-under-the-curve (AUC) of 0.855 (

P < 0.001

); (2) IUS key parameters (including BWT, CDS, BWS, and I-fat) yielded good predictive effects with AUC of 0.811, 0.731, 0.724, and 0.747, respectively (

P < 0.001

); (3) blood inflammatory markers (including ESR, CRP, PLR, MLR, and NLR) also had good predictive effects with AUC of 0.771, 0.837, 0.728, 0.743, and 0.775, respectively (

P < 0.001

); (4) IBUS-SAS combined with ESR and CRP exerted the best predictive effect with the highest AUC of 0.912 (95% CI: 0.823-1.000), and the sensitivity and specificity were 88.0% and 80.0%, respectively (

P < 0.001

). Conclusion. IBUS-SAS combined with ESR and CRP is a more efficient tool than IBUS-SAS alone or inflammatory markers alone in evaluating CD patients with moderate to severe disease activity.

背景和目的。肠超声(IUS)被认为是一种非照射、无创、耐受性良好、有价值的客观评估克罗恩病(CD)活动的工具。然而，目前还没有被广泛接受的肠道超声评分系统。本研究旨在评估IUS关键参数、国际肠超声活动评分(IBUS-SAS)以及IBUS-SAS联合血液炎症标志物评估CD活动的有效性。方法:在本回顾性研究中，40例CD患者根据克罗恩病简化内镜评分(SES-CD)分为中重度组(n = 25)和非中重度组(n = 15)。双气囊肠镜/结肠镜检查由三位胃肠病学家进行回顾。经腹部超声由两名超声专家进行。从早上的样本中测量血液炎症标志物。结果。在评估中重度CD患者时，(1)IBUS-SAS具有良好的预测效果，曲线下面积(AUC)为0.855 (P <0.001);(2) IUS关键参数(包括BWT、CDS、BWS和I-fat)具有较好的预测效果，AUC分别为0.811、0.731、0.724和0.747 (P <0.001);(3)血液炎症指标(ESR、CRP、PLR、MLR、NLR)也具有较好的预测作用，AUC分别为0.771、0.837、0.728、0.743、0.775 (P <0.001);(4) IBUS-SAS联合ESR、CRP的预测效果最好，AUC最高，为0.912 (95% CI: 0.823 ~ 1.000)，敏感性和特异性分别为88.0%和80.0% (P <0.001)。结论。在评估中度至重度疾病活动度的CD患者时，IBUS-SAS联合ESR和CRP是比单独使用IBUS-SAS或单独使用炎症标志物更有效的工具。

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引用次数: 0

Risk Factors for Single and Multiple Recurrences for Endoscopic Retrograde Cholangiopancreatography and Open Choledochotomy in Treating Choledocholithiasis. 内镜逆行胰胆管造影和开放式胆总管摄影术治疗胆总管综合征单次和多次复发的危险因素。

IF 2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterology Research and Practice

Pub Date : 2023-10-31 eCollection Date: 2023-01-01 DOI: 10.1155/2023/4738985

Yao Wu, Ying Zhang, Xiao Meng Jiang, Chen Jing Xu, Yan Yan Wang, Jin Yuan Gu, Yi Li, Shun Fu Xu

Background: There are few studies comparing recurrences between endoscopic retrograde cholangiopancreatography (ERCP) and open choledochotomy (OCT).

Aims: To compare the effect of different surgical methods on single and multiple recurrences of choledocholithiasis.

Methods: A total of 1255 patients with choledocholithiasis who underwent ERCP or OCT were retrospectively studied. The recurrence of choledocholithiasis was calculated by the Kaplan-Meier method with the log-rank test. Multivariate analyses of recurrent choledocholithiasis were performed by introducing variables with P < 0.20 in univariate analysis into the logistic regression model.

Results: A total of 204 (16.7%, 204/1225) patients relapsed. Among the 204 patients, 74.5% relapsed within three years after surgery, of whom 39.7% (81/204) had multiple relapses (≥ 2). The recurrence rate of ERCP (17.2%, 119/692) was higher than that of OCT (15.1%, 85/563), but the difference was not statistically significant. The independent risk factors for a single recurrence of choledocholithiasis were diabetes, stone number ≥ 2, maximum stone diameter ≥ 15 mm, sedentary occupation, the approach of ERCP (EST or EPBD), periampullary diverticulum, primary suture, high-fat diet (postoperative), frequency of weekly vegetable intake (< 4, postoperative), and drinking (postoperative). However, the ERCP approach (EST or EPBD), OCT approach (LCBDE), primary suture, high-fat diet (postoperative), and frequency of weekly vegetable intake (< 4, postoperative) were independent risk factors for multiple recurrences of choledocholithiasis.

Conclusion: Patients with choledocholithiasis should be followed up regularly for one to three years after treatment. Stone number ≥ 2, diabetes mellitus, periampullary diverticulum, surgical methods, and lifestyle are all risk factors for the recurrence of choledocholithiasis. ERCP is still the preferred surgical method based on the advantages of low risk of cholangitis recurrence, less hospital stay, minimally invasive surgery, fewer postoperative complications, and easier acceptance by elderly patients. In addition to optimizing the treatment plans, postoperative lifestyle management is also vital.

背景：很少有研究比较内镜逆行胰胆管造影（ERCP）和胆总管切开术（OCT）的复发情况。目的：比较不同手术方法对胆总管结石单次和多次复发的影响。方法：对1255例经ERCP或OCT检查的胆总管结石患者进行回顾性分析。采用Kaplan-Meier法结合log-rank检验计算胆总管结石的复发率。通过在逻辑回归模型中引入单变量分析中P＜0.20的变量，对复发性胆总管结石进行多变量分析。结果：共有204例（16.7%，204/1225）患者复发。在204例患者中，74.5%的患者在术后三年内复发，其中39.7%（81/204）有多次复发（≥ 2）。ERCP的复发率（17.2%，119/692）高于OCT（15.1%，85/563），但差异无统计学意义。胆总管结石单次复发的独立危险因素为糖尿病、结石数量≥2、最大结石直径≥15 mm、久坐、ERCP（EST或EPBD）入路、壶腹周围憩室、一期缝合、高脂饮食（术后）、每周蔬菜摄入频率（结论：胆总管结石患者治疗后应定期随访1～3年 ≥ 2、糖尿病、壶腹周围憩室、手术方法、生活方式等都是胆总管结石复发的危险因素。ERCP仍然是首选的手术方法，因为它具有胆管炎复发风险低、住院时间短、手术微创、术后并发症少、老年患者更容易接受等优点。除了优化治疗计划外，术后生活方式管理也至关重要。

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引用次数: 0

Correlation between Treatment Outcomes and Serum Vitamin D Levels As Well As Infliximab Trough Concentration among Chinese Patients with Crohn's Disease. 中国克罗恩病患者治疗结果与血清维生素D水平及英夫利昔单抗浓度的相关性。

IF 2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterology Research and Practice

Pub Date : 2023-10-06 eCollection Date: 2023-01-01 DOI: 10.1155/2023/6675401

Xiaomei Song, Huihui Zhang, Hao Wang, Zhongyue Li, Xiaoqin Zhou, Hong Guo

Background: The relationship between vitamin D (vit-D) levels and the effectiveness of infliximab (IFX) in patients with Crohn's disease (CD) remains controversial.

Objective: To evaluate the interaction between vit-D levels and the response to IFX therapy in patients with CD.

Methods: This was a retrospective cohort study. Serum vit-D and IFX trough concentrations (TC) were measured in 84 patients, and statistical analyses were performed.

Results: The total vit-D deficiency rate at enrollment, at week 14 and week 38, was 64.3%, 41.67%, and 37.5%, respectively (P < 0.001). CD activity index (CDAI) (120, range, 93-142.75) and simplified endoscopic activity score for CD (SES-CD) (2, range, 0-4) at week 14 were lower than that of enrollment (CDAI, 136.5, range, 101.25-196; SES-CD 13, range, 5-23) (P < 0.001). The biochemical remission (BR), clinical remission (CR), endoscopic remission (ER), and response (ERe) rates of week 38 were 76.1%, 88.5%, 22.4%, and 67.2%, respectively. vit-D levels at enrollment were positively correlated with CDAI at week 38 (P = 0.024). IFX serum TC was related to BR (P = 0.036), CR (P = 0.032) at week 14, and ERe (P = 0.009) at week 38.

Conclusion: Among Chinese patients with CD, vit-D levels prior to IFX therapy are related to CDAI scores, and IFX serum TC is associated with BR, CR, and ERe.

背景：克罗恩病（CD）患者维生素D（vit-D）水平与英夫利昔单抗（IFX）疗效之间的关系仍存在争议。目的：评估CD患者维生素D水平与IFX治疗反应之间的相互作用。方法：这是一项回顾性队列研究。测量了84例患者的血清维生素D和IFX谷浓度（TC），并进行了统计分析。结果：第14周和第38周的总维生素D缺乏率分别为64.3%、41.67%和37.5%，CD活性指数（CDAI）（120，范围，93-142.75）和CD简化内镜活性评分（SES-CD）（2，范围，0-4）在第14周低于入组（CDAI，136.5，范围，101.25-196；SES-CD 13，范围，5-23）（P<0.001）。第38周的生化缓解率（BR）、临床缓解率（CR）、内镜缓解率（ER）和反应率（ERe）为76.1%，分别为88.5%、22.4%和67.2%。入组时的维生素D水平与第38周的CDAI呈正相关（P=0.024）。IFX血清TC与BR（P=0.036）、14周的CR（P=0.032）和38周的ERe（P=0.009）相关。

{"title":"Correlation between Treatment Outcomes and Serum Vitamin D Levels As Well As Infliximab Trough Concentration among Chinese Patients with Crohn's Disease.","authors":"Xiaomei Song, Huihui Zhang, Hao Wang, Zhongyue Li, Xiaoqin Zhou, Hong Guo","doi":"10.1155/2023/6675401","DOIUrl":"10.1155/2023/6675401","url":null,"abstract":"Background: The relationship between vitamin D (vit-D) levels and the effectiveness of infliximab (IFX) in patients with Crohn's disease (CD) remains controversial.Objective: To evaluate the interaction between vit-D levels and the response to IFX therapy in patients with CD.Methods: This was a retrospective cohort study. Serum vit-D and IFX trough concentrations (TC) were measured in 84 patients, and statistical analyses were performed.Results: The total vit-D deficiency rate at enrollment, at week 14 and week 38, was 64.3%, 41.67%, and 37.5%, respectively (P < 0.001). CD activity index (CDAI) (120, range, 93-142.75) and simplified endoscopic activity score for CD (SES-CD) (2, range, 0-4) at week 14 were lower than that of enrollment (CDAI, 136.5, range, 101.25-196; SES-CD 13, range, 5-23) (P < 0.001). The biochemical remission (BR), clinical remission (CR), endoscopic remission (ER), and response (ERe) rates of week 38 were 76.1%, 88.5%, 22.4%, and 67.2%, respectively. vit-D levels at enrollment were positively correlated with CDAI at week 38 (P = 0.024). IFX serum TC was related to BR (P = 0.036), CR (P = 0.032) at week 14, and ERe (P = 0.009) at week 38.Conclusion: Among Chinese patients with CD, vit-D levels prior to IFX therapy are related to CDAI scores, and IFX serum TC is associated with BR, CR, and ERe.","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":"2023 ","pages":"6675401"},"PeriodicalIF":2.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10575748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41234310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Efficacy of 480 ml Oral Sodium Sulfate for Improving Insufficient Bowel Preparation of Colonoscopy with High-Concentrated Polyethylene Glycol. 480的功效 ml口服硫酸钠改善肠道不适高浓度聚乙二醇结肠镜检查准备。

IF 2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterology Research and Practice

Pub Date : 2023-09-30 eCollection Date: 2023-01-01 DOI: 10.1155/2023/6359165

Naohisa Yoshida, Yoshikazu Inagaki, Daisuke Hasegawa, Reo Kobayashi, Yuri Tomita, Hikaru Hashimoto, Ryohei Hirose, Osamu Dohi, Ken Inoue, Yasutaka Morimoto, Yutaka Inada, Takaaki Murakami, Yoshito Itoh

Objectives: Oral sulfate solution (OSS) is used for bowel preparation (BP) during colonoscopy. The way of taking this agent can be used a same-day regimen (only on the day of colonoscopy) and split regimen (the day before and on the day of colonoscopy) for receiving it. In this study, we analyzed the efficacy of a same-day regimen of 480 ml OSS for insufficient bowel preparation (BP) with high-concentrated polyethylene glycol (H-PEG).

Materials and methods: This multicenter retrospective study was conducted from December 2021 to December 2022 at three related institutions on patients aged ≥ 20 years with a fair or poor Aronchick score of BP with 1 l H-PEG in previous colonoscopy. All patients received a low-residual diet and 10 ml of 0.75% picosulfate sodium a day before the colonoscopy and 480 ml of OSS and ≥1 l of water 3 hours before the colonoscopy. We analyzed the rate of improvement with OSS compared to H-PEG and other efficacies, and adverse events (AE).

Results: We evaluated 125 cases (77 males) with an average age of 72.1 ± 8.8 years. The completion rate of 480 ml of OSS was 97.6% (122/125). The improvement rate of BP showing good or excellent score with OSS was 70.4% (88/125). Compared OSS with previous H-PEG, the insertion time (min) was 7.0 ± 4.8 vs. 8.1 ± 6.0 (p = 0.01), and the adenoma detection rates were 67.2% vs. 63.2% (p = 0.05). The cleansing time (min) was 131 ± 46 vs. 165 ± 53 (p < 0.01). The rate of AE with OSS was 10.4% (13/125). There were no significant differences about AE in age and gender. The tolerance of OSS compared with H-PEG (good/similar/bad) was 72.0%/24.8%/3.2% (amounts), 26.4%/39.2%/34.4% (taste), and 76.8%/10.4%/12.8% (overall preference), respectively.

Conclusions: The same-day regimen of 480 ml OSS effectively improved the insufficient BP of 1 l H-PEG.

目的：口服硫酸溶液（OSS）用于结肠镜检查期间的肠道准备（BP）。服用该药物的方式可以采用当天方案（仅在结肠镜检查当天）和分体式方案（结肠镜检查前一天和当天）。在本研究中，我们分析了480 ml OSS治疗高浓度聚乙二醇（H-PEG）肠道准备不足（BP）。材料和方法：这项多中心回顾性研究于2021年12月至2022年12月在三家相关机构对年龄≥20岁的患者进行，患者的Aroncick评分为1 l既往结肠镜检查中的H-PEG。所有患者均接受低残留饮食和10 结肠镜检查前一天服用0.75%皮硫酸钠ml，480 ml OSS且≥1 l结肠镜检查前3小时的水。我们分析了OSS与H-PEG相比的改善率和其他疗效，以及不良事件（AE）。结果：我们评估了125例（77名男性），平均年龄为72.1±8.8岁。480的完成率 ml OSS的阳性率为97.6%（122/125）。OSS评分良好或优良的BP改善率为70.4%（88/125）。OSS与以往H-PEG比较，插入时间（min）为7.0±4.8 vs.8.1±6.0（p=0.01），腺瘤检出率为67.2%vs.63.2%（p=0.05），清洗时间（min）为131±46 vs.165±53（p<0.01），OSS AE发生率为10.4%（13/125）。AE在年龄和性别上无显著差异。OSS与H-PEG（好/相似/坏）相比的耐受性分别为72.0%/24.8%/3.2%（量）、26.4%/39.2%/34.4%（味道）和76.8%/10.4%/12.8%（总体偏好）。结论：480的同一天方案 ml OSS有效改善了1 l H-PEG。

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引用次数: 0

Main Diagnostic Criteria Usually Does Not Work for Autoimmune Pancreatitis Wrongly Presuming Malignancy 误诊为恶性的自身免疫性胰腺炎的主要诊断标准通常不适用

4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterology Research and Practice

Pub Date : 2023-09-29 DOI: 10.1155/2023/6652881

Lei Gong, Bin Shu, Fei Yu, Xinjing Zhang, Jianfei Chen, Jirun Peng

Background. Autoimmune pancreatitis (AIP) usually responds dramatically to steroid therapy. Occasionally, however, misdiagnosed patients have undergone pancreaticoduodenectomy. This study is aimed at providing useful information to improve the accuracy of diagnosis before surgery and thus avoid unnecessary resections in patients with AIP. Methods. From January 2015 to February 2020, a series of patients were enrolled, having undergone pancreaticoduodenectomy for presumed malignancy. AIP diagnoses were confirmed by postoperative pathology. The demographic and clinical data of the AIP patients were evaluated. The main diagnostic criteria (HISORt, Asian, and ICDC) for AIP were applied to assess whether and how unnecessary surgery could have been avoided. Results. A total of 124 cases of pancreaticoduodenectomy were performed for presumed malignancy. Six patients were diagnosed with benign disease and five with AIP. The prevalences of benign disease and AIP were 4.8% and 4%, respectively. Four patients were female and 1 male, with a mean age of 60.0 years old. Jaundice, pain, and weight loss were observed in 100%, 20%, and 40% of AIP patients, respectively. The radiologic features of the AIP patients were a diffusely enlarged gland (40.0%), a focally enlarged gland (40.0%), pancreatic ductal dilatation (60.0%), upstream parenchymal atrophy (20.0%), bile duct thickening (66.0%), and bile duct stricture (40.0%). Based on the diagnostic criteria for AIP, surgery could have been avoided in two cases. Conclusions. IgG4 measurement and integrated use of major diagnostic criteria should be emphasized in every patient eligible for pancreaticoduodenectomies.

背景。自身免疫性胰腺炎(AIP)通常对类固醇治疗反应显著。然而，偶尔误诊的患者接受胰十二指肠切除术。本研究旨在提供有用的信息，以提高AIP患者术前诊断的准确性，从而避免不必要的切除。方法。2015年1月至2020年2月，纳入了一系列因推定为恶性肿瘤而行胰十二指肠切除术的患者。术后病理证实AIP诊断。对AIP患者的人口学和临床资料进行评估。应用AIP的主要诊断标准(HISORt、Asian和ICDC)来评估是否以及如何避免不必要的手术。结果。共124例胰十二指肠切除术推定为恶性肿瘤。6例诊断为良性疾病，5例诊断为AIP。良性疾病和AIP患病率分别为4.8%和4%。女性4例，男性1例，平均年龄60.0岁。在100%、20%和40%的AIP患者中分别观察到黄疸、疼痛和体重减轻。AIP患者的影像学表现为弥漫性腺体肿大(40.0%)、局灶性腺体肿大(40.0%)、胰管扩张(60.0%)、上游实质萎缩(20.0%)、胆管增厚(66.0%)、胆管狭窄(40.0%)。根据AIP的诊断标准，有两例可以避免手术。结论。IgG4的测定和主要诊断标准的综合应用应在每个符合胰十二指肠切除术条件的患者中得到强调。

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引用次数: 0

Retracted: Analysis of Hepatic Artery Infusion (HAI) Chemotherapy Using Randomized Trials of Floxuridine (FUDR) for Colon Cancer Patients with Multiple Liver Metastases. 撤回：分析肝动脉灌注 (HAI) 化疗与氟尿嘧啶 (FUDR) 随机试验对多发性肝转移的结肠癌患者的治疗效果。

IF 2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterology Research and Practice

Pub Date : 2023-08-16 eCollection Date: 2023-01-01 DOI: 10.1155/2023/9842084

Gastroenterology Research And Practice

[This retracts the article DOI: 10.1155/2022/3546455.].

[本文撤回了文章 DOI：10.1155/2022/3546455]。

引用次数: 0

Retracted: The Effect and Related Mechanism of Action of Astragalus Compatible with Curcumin against Colon Cancer Metastasis in Mice. 撤稿：黄芪与姜黄素配伍对小鼠结肠癌转移的影响及相关作用机制

IF 2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterology Research and Practice

Pub Date : 2023-08-16 eCollection Date: 2023-01-01 DOI: 10.1155/2023/9793254

Gastroenterology Research And Practice

[This retracts the article DOI: 10.1155/2022/9578307.].

[本文撤回了文章 DOI：10.1155/2022/9578307.]。

引用次数: 0

Acupuncture Improved the Function of the Lower Esophageal Sphincter and Esophageal Motility in Chinese Patients with Refractory Gastroesophageal Reflux Disease Symptoms: A Randomized Trial. 针刺改善中国难治性胃食管反流病患者下食管括约肌功能和食管运动:一项随机试验

IF 2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterology Research and Practice

Pub Date : 2023-05-24 eCollection Date: 2023-01-01 DOI: 10.1155/2023/4645715

Tang Yuming, Zhao Yuping, Lin Yihan, Zhu Ying, Huang Jia, Shen Hanbing, Zou Duowu, Yao Weiyan

Objectives: Acupuncture is therapeutic for refractory gastroesophageal reflux disease by an unclear mechanism. This study was aimed at investigating the effect of acupuncture on esophageal motility in patients with symptoms of refractory gastroesophageal reflux disease.

Methods: Sixty-eight patients with refractory gastroesophageal reflux disease symptoms were prospectively enrolled from August 2014 to December 2018 and randomized into acupuncture and control groups (n = 33 and 35, respectively). The acupuncture group received acupuncture, and the control group received sham acupuncture. Pre- and post-acupuncture high-resolution manometry was performed to evaluate the effect of acupuncture on esophageal motility. The GerdQ questionnaire was used to evaluate the pre- and post-intervention symptoms.

Results: After acupuncture, there was a significant increase in the length of lower esophageal sphincter (3.10 ± 1.08 cm vs. 3.78 ± 1.01 cm), length of intra-abdominal lower esophageal sphincter (2.14 ± 1.05 cm vs. 2.75 ± 1.16 cm), and mean basal pressure of lower esophageal sphincter (22.02 ± 10.03 mmHg vs. 25.06 ± 11.48 mmHg) in the acupuncture group (P = 0.014); moreover, the numbers of fragmented contraction and ineffective contraction decreased from 36 to 12 (P < 0.001) and 43 to 18 (P = 0.001), respectively, in the acupuncture group. However, no significant difference was observed in the control group. The GerdQ score decreased significantly from 9.45 ± 2.44 to 7.82 ± 2.21 points in the first week after acupuncture (P < 0.001).

Conclusions: Acupuncture, which improves esophageal motility, has short-term efficacy in patients with symptoms of refractory gastroesophageal reflux disease. This trial is registered with Chinese Clinical Trial Registry (ChiCTR1800019646).

目的：针灸治疗难治性胃食管反流病的作用机制尚不明确。本研究旨在探讨针刺对难治性胃食管反流病患者食管运动的影响。方法：从2014年8月至2018年12月，68名有难治性胃食管反流疾病症状的患者前瞻性入选，并随机分为针灸组和对照组（分别为33和35）。针刺组采用针刺，对照组采用假针刺。采用针刺前后高分辨率测压来评价针刺对食管运动的影响。GerdQ问卷用于评估干预前后的症状。结果：针刺后食管下括约肌长度明显增加（3.10±1.08） cm与3.78±1.01 cm），腹内食管下括约肌长度（2.14±1.05 cm与2.75±1.16 cm）和食管下括约肌平均基础压力（22.02±10.03 mmHg与25.06±11.48 mmHg）（P=0.014）；此外，针刺组的收缩碎片数和收缩无效数分别从36减少到12（P＜0.001）和43减少到18（P＝0.001）。然而，在对照组中没有观察到显著差异。针刺后第1周GerdQ评分由9.45±2.44分降至7.82±2.21分（P＜0.001）。本试验在中国临床试验注册中心（ChiCTR1800019646）注册。

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引用次数: 2

Astaxanthin Alleviates Inflammatory Response in Neonatal Necrotizing Enterocolitis Rats by Regulating NOD2/TLR4 Pathway. 虾青素通过调节 NOD2/TLR4 通路缓解新生儿坏死性小肠结肠炎大鼠的炎症反应

IF 2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterology Research and Practice

Pub Date : 2023-03-27 eCollection Date: 2023-01-01 DOI: 10.1155/2023/6078308

Xuandong Zhang, Yujia Luo, Rui Gu, Zhou Jiang

Background: Necrotizing enterocolitis (NEC) is often associated with exaggerated activation of inflammatory response. Astaxanthin has been shown in studies to have a positive and advantageous effect on anti-inflammatory response. Hence, it is of great significance to study the protective effect of astaxanthin in NEC disease and its molecular mechanism.

Objective: The present study was to investigate whether astaxanthin attenuates NEC rats and to explore its potential mechanism. Material and Methods. Hematoxylin-eosin staining was used to observe the pathological change of the intestinal tissue in NEC rats. Subsequently, we determined the anti-oxidative stress, anti-apoptosis, and anti-inflammation in astaxanthin with enzyme-linked immunosorbent assay kits, TUNEL staining, western blot, and immunohistochemistry assay. Furthermore, we added nucleotide-binding oligomerization domain 2 (NOD2) inhibitor to certify the molecular pathway of the astaxanthin in NEC rats.

Results: Astaxanthin improved the pathological changes of the intestinal tissues. It restrained inflammation, oxidative stress, and protected cells from apoptosis in the intestinal tissue and serum of the NEC rats. Moreover, astaxanthin enhanced NOD2, whereas it suppressed toll-like receptor 4 (TLR4), nuclear factor-κB (NF-κB) pathway-related proteins. Apart from that, the NOD2 inhibitor offset the protective effect of the astaxanthin towards the NEC rats.

Conclusion: The present study indicated that astaxanthin alleviated oxidative stress, inflammatory response, and apoptosis in NEC rats by enhancing NOD2 and inhibiting TLR4 pathway.

背景：坏死性小肠结肠炎（NEC坏死性小肠结肠炎（NEC）通常与炎症反应的过度激活有关。研究表明，虾青素对抗炎反应具有积极和有利的作用。因此，研究虾青素对NEC疾病的保护作用及其分子机制具有重要意义：本研究旨在探讨虾青素是否能减轻NEC大鼠的病情，并探索其潜在机制。材料和方法。采用血红素-伊红染色法观察NEC大鼠肠道组织的病理变化。随后，我们通过酶联免疫吸附试验、TUNEL染色、Western印迹和免疫组化测定虾青素的抗氧化应激、抗凋亡和抗炎作用。此外，我们还添加了核苷酸结合寡聚化结构域2（NOD2）抑制剂，以证实虾青素在NEC大鼠中的分子途径：结果：虾青素改善了肠道组织的病理变化。结果：虾青素改善了NEC大鼠肠道组织的病理变化，抑制了肠道组织和血清中的炎症、氧化应激和细胞凋亡。此外，虾青素还能增强 NOD2，而抑制收费样受体 4 (TLR4)、核因子-κB (NF-κB)通路相关蛋白。此外，NOD2 抑制剂抵消了虾青素对 NEC 大鼠的保护作用：本研究表明，虾青素通过增强NOD2和抑制TLR4通路，减轻了NEC大鼠的氧化应激、炎症反应和细胞凋亡。

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